Objective To investigate the relation of changes of fetal bile acid and morphologic ultrastructure of human placental syncytial cells in intrahepatic cholestasis of pregnancy (ICP). Methods(Total bile acid of cord venous blood was measured by cycle enzyme method between intrahepatic cholestasis of pregnancy and control groups after birth. The ultrastructure of human placental syncytial cell was analyzed by morphologic study in two groups. Results (1) The total bile acid of cord venous blood in ICP group was significantly higher than in control group[(8.6?3.2) ?mol/L vs (4.6?1.5)?mol/L ](P0.05). The average volume, surface area density and volume density of mitochondrion in ICP group [respectively (0.0200?0.0020) ?m~3,(0.600?0.010) ?m~2/?m~3,(0.0800?0.0090)?m~3/?m~3] were significantly enlarged than in control group [respectively (0.0100?0.0050)?m~3, (0.500?0.030) ?m~2/?m~3,(0.0500?0.0020) ?m~3/?m~3](P0.05). Conclusion In ICP, high levels of bile acids may impair cellular organelle, resulting in abnormality of physiological function of syncytial cells, and affecting the synthesis and transportation functions of placenta.

OBJECTIVE: To investigate the use of psychotropic substances for outpatients in our hospital.METHODS: The psychiatric substances used in the outpatients between June and December in 2006 were analyzed statistically in respect of the defined daily dose,DDDs and average daily expense etc.RESULTS: Of the total 7 286 prescriptions analyzed,the psychotropic substances prescribed totaled 12 kinds,of which,2 were typeⅠ,and 10 type Ⅱ.Estazolam,Alprazolam and Diazepam ranked at the first three places in terms of numbers of prescriptions;Estazolam,Alprazolam and Clonazepam ranked at the first three places in terms of DDDs;Zolpidem,Midazolam and Alprazolam ranked at the first three places in terms of consumption sum;Nitrazepam,Estazolam and Phenobarbital ranked at the lowest places in terms of average daily expense.CONCLUSION: Of the total psychiatric substances consumed in the outpatients of our hospital,benzodiazepines were used predominantly for their merits of low cost but proved efficacy.

Objective To define the role of HCV-specific cytotoxic T lymphocytes (CTL) in chro-nic hepatitis C virus (HCV) infection. Methods HCV-specific CTL activity (HCV-CTL) was assessed in the liver and peripheral blood cells in 62 patients with chronic hepatitis C and 8 non-HCV-infection controls by using bulk-expanded liver/peripheral blood mononuclear lymphocytes (PBMC)-derived CD8+ cells as effector cells, EBV-transformed B cells as autologous target cells and recombinant vaccinia vectors expressing various regions of the HCV genome as transduction vector, in a standard chromium release assay. Results HCV-CTL activity was detected from the liver in 28 of the 60 patients (46.7%), but not from PBMC. CTL activity could not be detected from the liver and PBMC in all non-HCV-infection controls. Five patients with non-type 1 HCV infection were found to have HCV-specific CTL activity against HCV type 1 epitope. Compared with the patients without detectable HCV-specific CTL activity based on our assay, those exhibiting CTL activity had higher serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, higher histologic activity indices and lower levels of HCV RNA (all P

Objective To determine the influence of viral factors and host cellular immunity on the response to interferon in the patients with chronic hepatitis C. Methods Forty patients with chronic hepatitis C were treated with interferon ?. The relationships between response to interferon a and HCV genotype, quasispecies heterogeneity, HCV RNA level and HCV specific cytotoxic T lymphocyte (HCV CTL) activity in the liver were analyzed. Results After 6 months of therapy, 21 patients had obtained end of treatment response (ETR), 10 Patients of which had obtained sustained response (SR). The other 19 patients got no response (NR). ETR rate in patients with genotype HCV1 infection (43.3%, 13/30) was significantly lower than that in patients with non HIV1 infection (80%, 8/10) [ P

The literature courses in military medical university have two main difficulties:fuzzy teaching purpose and single teaching forms. To tackle the two difficulties,firstly,the literature courses should have specific aim which includes medical characteristics and practicality. Secondly, the teachers should choose reasonable materials and adopt effective teaching forms and then better teaching effect can be obtained.

Referred to books and literatures, the data were summarized and analyzed, and compared with western medicine phar-maceutical service to find the current problems in traditional Chinese medicine ( TCM) pharmaceutical service. According to the prob-lems and characteristics of TCM pharmaceutical service, and based on the theoretical characteristics of Chinese medicine, some sugges-tions for the development of TCM pharmaceutical service were proposed.

Objective To investigate the expression of p73 protein in normal skins and lesions of benign and malignant epidermal tumors. Methods By immunohistochemical staining, the expression of p73, p53 and Ki67 was examined in 19 cases of seborrheic keratosis (SK), 16 basal cell carcinoma (BCC), 11 Bowen's disease (BD), 5 squamous cell carcinoma (SCC),as well as in 10 normal skin controls. Results In normal skin, p73 protein was found to distribute in the basal cells of the epidermis, basal cells in the outer root sheath of the hair follicles, and the germinative cells in the sebaceous glands. p73 was expressed strongly in the basal cell-like cells of BCC and SK lesions, and in the atypical cells of BD lesions, but weakly or even negatively in the tumor cells of SCC lesions and the squamous cell-like cells of SK lesions. There was significant difference in the expression of p73 among the SK, BD, BCC and SCC lesions (H=12.71 ,P

Objective:To investigate the therapeutic efficacy of Golimumab in the treatment of children with refractory juvenile dermatomyositis(JDM).Methods:The clinical data of a child diagnosed with JDM in the Department of Allergy, Immunology and Rheumatology of Guangzhou Women and Children′s Medical Center in February 2019 were collected.The treatment effect was studied and literature review was conducted.Results:The patient was a 7-year-old boy with subacute onset of the disease.The illness protracted, and main manifestations included skin rashes, limb weakness, and swallowing dysfunction.Physical examination showed heliotropic rashes, Gottron papules, positive Gower, proximal limb muscle strength grade Ⅲ-Ⅳ, distal limb muscle strength grade Ⅳ, and a choking cough when swallowing fluid food.Laboratory tests revealed alanine aminotransferase (ALT) of 36 U/L, aspartate aminotransferase (AST) of 115 U/L, alkaline phosphatase of 69 U/L, lactate dehydrogenase of 941 U/L, creatine kinase of 974 U/L, hypersensitive C-reactive protein of 26 mg/L and an erythrocyte sedimentation rate (ESR) of 52 mm/1 h. Antinuclear antibody spectra were negative.Electromyography suggested myogenic damage.Thigh magnetic resonance imaging indicated diffuse abnormal signal shadows in the subcutaneous fat, muscles and muscle spaces of both hips, thighs and knee joints.The child was diagnosed with JDM, and given standardized treatment of Methylprednisolone, intravenous immunoglobulin, Methotrexate and Hydroxychloroquine sulfate.However, after the treatment, the facial rashes were still red, proximal limb muscle strength and swallowing dysfunction did not improve, the choking cough symptom still existed, and a Cushing face appeared.Recheck results showed ALT of 24 U/L, AST of 32 U/L, alkaline phosphatase of 56 U/L, lactate dehydrogenase of 216 U/L, creatine kinase of 527 U/L, hypersensitive C-reactive protein of 8 mg/L and an ESR of 15 mm/1 h. Refractory JDM was considered.After negotiating with the patient′s family members, they agreed to treat the patient with Golimumab 50 mg by subcutaneous injection once a month.Then tapered prednisone gradually, stopped Hydroxychloroquine sulfate tablets and continued to give the patient oral Methotrexate.After two doses of Golimumab 50 mg, proximal limb muscle strength and swallowing function improved markedly.After the third subcutaneous injection of Golimumab, proximal limb muscle strength improved to grade Ⅳ-Ⅴ, and he was able to go up and down stairs, squat and stand up after squatting.Besides, dysphagia and the choking cough disappeared, and skin rashes improved.Recheck results suggested a normal ESR and creatine kinase levels.Magnetic resonance imaging of thighs indicated no muscle inflammation.Conclusions:Golimumab works well in the treatment of refractory JDM and can effectively improve muscle strength.Therefore, it can be used as a treatment option for refractory JDM.

Objective:To develop a set of algorithms that could predict the precise size of acetabular cup preoperatively by the deep learning neural network technology.Methods:Retrospective analysis was performed on 30 patients with femoral head necrosis from April 2019 to April 2020, including 15 males and 15 females. At the age of (54.8±10.5) years (range 33-72 years). Thirteen hips on the left and seventeen hips on the right, who underwent primary unilateral THA. Based on the manually segmented hip joint CT database, a deep learning convolutional neural network was trained to realize automatic segmentation. A customized algorithm was created to fit the surface of the acetabulum. By the application of another deep learning convolutional neural network, the identification of anatomical points of the pelvis and correction of the pelvic position were realized. So that the placement of the acetabulum cup could be done. DOC (dice overlap coefficients) as well as the average error parameter were adopted to evaluate the accuracy of the above steps. The novel algorithm and Orthoview software were retrospectively used to template the acetabular cup separately. The results of both groups were compared with the actual size and the coincidence rate was calculated to evaluate the accuracy of the novel algorithm. To verify this algorithm, the conformance rate was calculated respectively.Results:Compared with other classical segmentation networks, the G-NET network can segment the pelvic with femoral head necrosis more accurately (DOC 92.51%± 6.70%). It also has better robustness. The average error of the point recognition network is 0.87 pixels. Among the 30 patients, the AI-based algorithm group had a complete coincidence rate of 96.7% and the Orthoview group had a complete coincidence rate of 73.3%. The difference was statistically significant ( χ2=6.405, P=0.011). Conclusion:The artificial intelligence-based algorithm can segment the CT image series and identify the feature points of the patient's hip accurately. Compared with the conventional 2D preoperative planning method, the AI-based algorithm is relatively more accurate. This artificial intelligence-based 3D preoperative software has promising prospect to makeaccurate surgical plan efficiently.

Objective To investigate the clinical value of hemostatic silk in prevention of wound bleeding and wound healing after endoscopic submucosal dissection (ESD). Methods Experiment group: animal model was made by rabbit underwent ESD simulation in its' stomach and laying hemostatic silk on its' wound;control group: animal model was made by pig underwent ESD simulation in its' colon without any healing management. All the ulcers sites were endoscopically and pathologically examined to evaluate the hemorrhage and healing of the wound on 3 days, 1 week, 2 weeks and 4 weeks after the procedure. Results The blood loss in experiment group was significantly lower than that in control group. The wounds of all the experimental pigs underwent colon ESD successfully covered with hemostatic silk postoperatively. Endoscopic pathological examination shown better healing procedure in experiment group. No procedure-related adverse event occurred in both groups. Conclusions Hemostatic silk has potential application value in healing the wound after ESD demonstrated by animal experiment.